Evaluation of the learning environment of urology residency training using the postgraduate hospital educational environment measure inventory

Figures & data

Table 1 Characteristics of study respondents

	Number	Percentage
Sex
Male	33	97.1
Female	1	2.9
Residency stage
R2	6	17.6
R3	9	26.5
R4	12	35.3
R5	7	20.6
Region in Saudi Arabia
Central	16	47.0
Western	7	20.6
Eastern	6	17.6
Northern	1	2.9
Southern	4	11.8
Sector of health service
Ministry of Health	11	32.4
National Guard Hospital	5	14.7
Armed Forces Hospital	5	14.7
Security Forces Hospital	3	8.8
University Hospital	6	27.6
Others	4	11.8

Table 2 Mean and median of each question, overall and subscales scores

	Mean (SD)	Median
Q1 I have a contract of employment that provides information about hours of work	1.5 (1.1)	1
Q2 My clinical teachers set clear expectations	1.6 (0.9)	2
Q3 I have protected educational time in this post	2.0 (1.1)	2
Q4 I had an informative induction program	1.4 (1.2)	1
Q5 I have the appropriate level of responsibility in this post	2.0 (0.9)	2
Q6 I have good clinical supervision at all times	2.2 (1.0)	2
Q7 There is racism in this post	2.7 (1.0)	2.5
Q8 I have to perform inappropriate tasks	2.2 (1.1)	2
Q9 There is an informative Junior Doctors handbook	1.4 (0.9)	1
Q10 My clinical teachers have good communication skills	2.2 (0.9)	2
Q11 I am bleeped inappropriately	1.7 (0.8)	2
Q12 I am able to participate actively in educational events	2.6 (0.9)	3
Q13 There is sex discrimination in this post	2.5 (1.1)	2
Q14 There are clear clinical protocols in this post	1.4 (1.1)	1
Q15 My clinical teachers are enthusiastic	1.8 (0.8)	2
Q16 I have good collaboration with other doctors in my grade	2.5 (0.8)	2
Q17 My working hours conform to the new deal	1.7 (0.8)	2
Q18 I have the opportunity to provide continuity of care	2.5 (0.7)	2.5
Q19 I have suitable access to careers advice	2.0 (1.0)	2
Q20 This hospital has good quality accommodation for junior doctors, especially when on call	1.6 (1.4)	1
Q21 There is access to an educational program relevant to my needs	1.6 (1.0)	2
Q22 I get regular feedback from seniors	1.7 (1.0)	2
Q23 My clinical teachers are well organized	1.8 (1.0)	2
Q24 I feel physically safe within the hospital environment	2.4 (1.0)	2
Q25 There is a no-blame culture in this post	1.5 (0.8)	2
Q26 There are adequate catering facilities when I am on call	1.0 (0.9)	1
Q27 I have enough clinical learning opportunities for my needs	1.6 (0.7)	1
Q28 My clinical teachers have good teaching skills	1.6 (0.7)	2
Q29 I feel part of a team working here	2.5 (1.1)	3
Q30 I have opportunities to acquire the appropriate practical procedures for my grade	2.2 (0.9)	2
Q31 My clinical teachers are accessible	2.7 (0.9)	3
Q32 My workload in this job is fine	1.9 (0.9)	2
Q33 Senior staff utilize learning opportunities effectively	1.9 (0.9)	2
Q34 The training in this post makes me feel ready to be a consultant	1.7 (0.9)	2
Q35 My clinical teachers have good mentoring skills	2.1 (0.7)	2
Q36 I get a lot of enjoyment out of my present job	2.2 (1.0)	2
Q37 My clinical teachers encourage me to be an independent learner	2.4 (1.0)	2.5
Q38 There are good counseling opportunities for junior doctors who fail to complete their training satisfactorily	1.5 (0.8)	2
Q39 The clinical teachers provide me with good feedback on my strengths and weaknesses	1.6 (0.8)	2
Q40 My clinical teachers promote an atmosphere of mutual respect	2.1 (1.0)	1
Total score	77.7 (16.5)	75
Autonomy subscale	26.18 (6.5)	25
Teaching subscale	29.7 (7.7)	29
Social support subscale	21.9 (4.3)	22

Abbreviations: Q, question; SD, standard deviation.

Table 3 Comparison of PHEEM scores of respondents from different health care sectors

	Mean rank	P
Health sector total inventory score
Ministry of Health	11.32	0.024
National Guard hospitals	29.90
Armed Forces hospitals	21.10
Security Forces hospitals	16.67
University hospitals	17.50
Others	15.13
Health sector autonomy subscale
Ministry of Health	14.45	0.079
National Guard hospitals	29.80
Armed Forces hospitals	18.40
Security Forces hospitals	17.17
University hospitals	13.75
Others	15.25
Health sector teaching subscale
Ministry of Health	11.05	0.017
National Guard hospitals	29.70
Armed Forces hospitals	22.20
Security Forces hospitals	17.67
University hospitals	17.58
Others	13.88
Health sector social support subscale
Ministry of Health	10.32	0.079
National Guard hospitals	23.40
Armed Forces hospitals	20.20
Security Forces hospitals	16.00
University hospitals	22.67
Others	19.88
Q2
Ministry of Health	15.45	0.034
National Guard hospitals	28.00
Armed Forces hospitals	20.10
Security Forces hospitals	7.17
University hospitals	18.75
Others	12.63
Q3
Ministry of Health	18.77	0.022
National Guard hospitals	30.30
Armed Forces hospitals	15.40
Security Forces hospitals	12.17
University hospitals	11.58
Others	13.50
Q4
Ministry of Health	17.23	0.029
National Guard hospitals	29.80
Armed Forces hospitals	17.30
Security Forces hospitals	18.67
University hospitals	10.42
Others	12.88
Q10
Ministry of Health	10.77	0.035
National Guard hospitals	23.30
Armed Forces hospitals	24.50
Security Forces hospitals	15.33
University hospitals	21.83
Others	15.13
Q12
Ministry of Health	15.23	0.018
National Guard hospitals	28.40
Armed Forces hospitals	17.80
Security Forces hospitals	18.67
University hospitals	8.75
Others	22.00
Q21
Ministry of Health	9.86	0.009
National Guard hospitals	26.40
Armed Forces hospitals	17.20
Security Forces hospitals	21.67
University hospitals	16.75
Others	25.75
Q24
Ministry of Health	10.45	0.014
National Guard hospitals	28.50
Armed Forces hospitals	15.20
Security Forces hospitals	22.83
University hospitals	20.08
Others	18.13
Q29
Ministry of Health	11.45	0.048
National Guard hospitals	22.00
Armed Forces hospitals	25.80
Security Forces hospitals	15.50
University hospitals	21.50
Others	13.63
Q32
Ministry of Health	19.55	0.014
National Guard hospitals	28.00
Armed Forces hospitals	12.60
Security Forces hospitals	18.00
University hospitals	15.58
Others	7.38
Q33
Ministry of Health	11.68	0.044
National Guard hospitals	25.10
Armed Forces hospitals	20.60
Security Forces hospitals	25.83
University hospitals	18.33
Others	12.63

Abbreviations: PHEEM, postgraduate hospital educational environment measure; Q, question.

Table 4 Reliability analysis of the overall questionnaire

	Scale mean if item deleted	Scale variance if item deleted	Corrected item-total correlation	Cronbach’s alpha if item deleted
Q1	76.24	260.367	0.341	0.890
Q2	76.12	258.955	0.478	0.888
Q3	75.71	253.729	0.506	0.887
Q4	76.38	253.880	0.461	0.888
Q5	75.74	256.564	0.542	0.887
Q6	75.50	256.924	0.491	0.888
Q7	75.09	259.053	0.410	0.889
Q8	75.56	260.981	0.331	0.890
Q9*	76.32	268.953	0.119	0.893
Q10	75.53	255.651	0.579	0.886
Q11	76.00	265.333	0.307	0.890
Q12	75.18	255.544	0.574	0.886
Q13	75.26	260.140	0.348	0.890
Q14	76.29	254.759	0.508	0.887
Q15	75.91	257.780	0.619	0.887
Q16*	75.21	268.411	0.160	0.892
Q17*	76.00	268.606	0.152	0.893
Q18	75.21	264.532	0.392	0.890
Q19*	75.76	267.034	0.172	0.893
Q20*	76.15	259.038	0.289	0.892
Q21*	76.15	264.796	0.247	0.892
Q22	76.09	256.143	0.538	0.887
Q23	75.94	255.390	0.588	0.886
Q24	75.32	255.074	0.515	0.887
Q25*	76.24	267.337	0.200	0.892
Q26*	76.74	273.655	–0.035	0.895
Q27*	76.18	265.544	0.301	0.891
Q28	75.71	258.093	0.546	0.887
Q29	75.21	254.532	0.530	0.887
Q30	75.59	258.977	0.496	0.888
Q31	75.00	256.788	0.550	0.887
Q32*	75.85	266.978	0.179	0.893
Q33	75.82	253.604	0.691	0.885
Q34	76.09	261.356	0.378	0.889
Q35	75.68	259.801	0.587	0.887
Q36*	75.53	270.378	0.057	0.895
Q37*	75.32	264.286	0.254	0.892
Q38	76.26	264.685	0.316	0.890
Q39	76.18	259.241	0.509	0.888
Q40	75.65	252.478	0.652	0.885

Note:

* Questions 9, 16, 17, 19, 20, 21, 25, 26, 27, 32, 36, and 37 are not consistent with the rest of the scale.

Abbreviation: Q, question.